The Victim-Centered Approach

By Samantha Diamond, MPH Candidate Yale University

The beginnings of the prison started by the government of Haiti in 2008 and abandoned one year later.

Arriving in Hinche, I was struck by the sudden transition from rocky terrain to cobblestone streets. The relative wealth made the prison conditions seem all the more inhumane. After a military invasion in February 2004, the prison of Hinche was set on fire and pillaged.

The government of Haiti began construction on a new prison in 2008. This prison was built to have 16 cells with 8 prisoners per cell.

Though I had watched the New Media Advocacy Project’s video of the BAI’s Prison Project in the Hinche prison, I did not fully grasp the conditions until I felt the 115 degree heat and smelled the stench wafting out of a 20×20 foot cell with 67 men crammed inside. With 6 square feet per person, the prison density is five times the Red Cross’ maximum density for emergency situations.

TB and HIV/AIDS make prisoners more vulnerable to opportunistic infections that plague the prisons. The first of a four recent deaths occurred in February. The most recent case was a 27 year old man who was taken to the hospital July 3rd and died the next day. BAI’s on-site lawyer in Hinche, Ouvens Jean Louis, said the 27 year old prisoner had been on ARVs, but looked malnourished and by the time he got to the hospital, it was clear that he was only there for his last meal.

Because the young man died at the hospital, it was not recorded at the prison. Guards still do not know the cause of death. According to Michelle Karshan of Health Through Walls, throughout Haiti, prison guards are reluctant to send prisoners to hospitals because of security concerns. As a result, they wait until the last minute and the hospitals are reluctant to take patients who have little chance of recovery.

Without the necessary nutrition, ARVs are significantly less effective. In Haiti, prisoners receive two meager meals a day. Most detainees depend on their relatives to bring them supplemental food and water. While food is mandated by Haitian law, there is no regulation for water, despite international standards binding on Haiti.

After paying 80 Haitian Dollars (US$10) to travel to St. Marc, one 60 year old mother reports that she tried to deliver water for her son, and was asked to pay the guard to deliver the water. Other women report being asked for “sexual favors” by guards in order to “ensure” the food or water gets to the right person.

I am overwhelmed trying to determine what to report, to whom, and how to approach a system riddled with problems. However, Mario Joseph, BAI’s managing attorney, is steadfast and determined to change the system. Recently, BAI on-site lawyer, Bazelais Thevenot, found that his clients were not receiving food on days they were in court. Mario visited the prison officials in Mirebalais, St. Marc, and Hinche, to plant the seeds of change. Next week he has an appointment with the regional prison authority to create a system to feed prisoners at the court house. Mario aims to “do more than make change at the superficial level,” or accomplish an agenda, but instead to “listen, understand, and respond” to needs through a victim-centered approach.

Mario Joseph, BAI’s managing attorney, talking to some people near his home town.

BAI, IJDH, and Partners in Health, along with the FXB Center and Partners in Health, are working together on the Health and Human Rights Prison Project to address the needs of detainees. This project aims to meet the immediate medical needs of detainees, but also to address the legal causes of these symptoms of overcrowding by advocating against prolonged pretrial detention.